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deSouza IS, Martindale JL, Sinert R.  Antidysrhythmic drug therapy for the termination of stable, monomorphic ventricular tachycardia: a systemic review. Emerg Med J. 2015;32(2):161-167. doi:10.1136/emermed-2013-202973

In this systematic literature review, the authors compared the efficacy of different drug therapies for the termination of stable, monomorphic ventricular tachycardia (VT).  The literature search yielded a total of 609 articles, of which 5 studies were reviewed.  Per the authors, all reviewed studies had quality issues.  Based on limited available evidence, for the treatment of stable, monomorphic VT, procainamide, ajmaline and sotalol were all superior to lidocaine; amiodarone was not more effective than procainamide. https://pubmed.ncbi.nlm.nih.gov/24042252/

Highlights of Prescribing Information

Boxed Warning, Indications, and Important Safety Information

WARNING: LIFE THREATENING PROARRHYTHMIA

Sotalol can cause life threatening ventricular tachycardia associated with QT interval prolongation. To minimize the risk of drug induced arrhythmia, initiate or uptitrate intravenous sotalol in a facility that can provide continuous electrocardiographic monitoring and cardiac resuscitation [see Dosage and Administration (2.3) and Warnings and Precautions (5.1)].
Do not initiate intravenous sotalol therapy if the baseline QTc is longer than 450 ms. If the QTc prolongs to 500 ms or greater, reduce the dose or discontinue. (2.3)